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NPI Code Detail

MEDICARE: JONATHAN KLINE MSW

MEDICARE:   JONATHAN  KLINE  MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1619417672
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN KLINE MSW
Provider Business Mailing Address
First Line : 365 W REED RD STE A-1
Second Line :
City : GREENVILLE
State : MS
Zip : 38701-6967
Country : US
Telephone Number : 662-702-5108
Fax Number : 662-702-5106
Provider Business Practice Location Address
First Line : 365 W REED RD STE A-1
Second Line :
City : GREENVILLE
State : MS
Zip : 38701-6967
Country : US
Telephone Number : 662-702-5108
Fax Number : 662-702-5106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2017
Last Update Date : 02/24/2017

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Directions to “ JONATHAN KLINE MSW” Practice Location

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